In 2010, the Institute of Medicine (IOM) released its landmark report, The Future of Nursing: Leading Change, Advancing Health, which challenged nurses in this rapidly changing health care environment. The Robert Wood Johnson Foundation (RWJF) in partnership with AARP launched a widely executed Campaign for Action carried out at the national and state levels. Now, five years later, the RWJF asked the IOM to convene a committee and examine changes that have been a direct result within nursing and those concurrent changes in health care such as the Affordable Care Act that have impacted the Campaign and other stakeholders to implement the recommendations of the IOM Report.

The findings of the new report are a commendation on the progress that the nursing profession has made and a call for action on several fronts, including nursing education. According to the update, the Campaign has made significant progress in “galvanizing the nursing community” and “meeting or exceeding expectations in many areas.” They recommend, however, engaging a broader network of stakeholders in several areas including nursing education.

As co-chair of the Nursing Section of NYAM and editor of NURSING ECONOMIC$, Donna Nickitas has written and spoken to wide audiences on the important role of nurse educators in the preparation of a nursing workforce that is agile and ready for a changing health care system. She views nurse educators as stakeholders on the front line with the moral imperative to self-reflect on how to best optimize the years that students spend in their preparation to serve as the next generation of nurses.

We interviewed Dr. Nickitas about why she sees nurse educators to be central to the IOM FUTURE OF NURSING REPORT UPDATE recommendations directly and indirectly through the students they prepare.

Donna M. Nickitas, is Professor and Executive Officer of the Nursing PhD Program at the CUNY Graduate Center. She is also the Editor of NURSING ECONOMIC$. Dr. Nickitas has been an outspoken leader in nursing education, receiving numerous awards and citations for her works including the recent NLN Mary Adelaide Nutting Award for Outstanding Teaching or Leadership in Nursing Education, where she spoke passionately at the National League for Nursing (NLN) Summit on the pivotal roles that all educators play in shaping the future of nursing and impacting the future of health care. Dr. Nickitas is also the co-author of the widely used text book POLICY AND POLITICS FOR NURSES AND OTHER HEALTH PROFESSIONALS: ADVOCACY AND ACTION, published by Jones & Bartlett.

We asked her to elaborate on her comments in the NLN Mary Adelaide Nutting address by answering 3 Questions!

Veronica D. Feeg, PhD, RN, FAAN
Editor/Moderator

We invite commentary that is thoughtful and provocative! Join the online dialogue!

Donna M. Nickitas, PhD, RN, NEA-BC, CNE, FAAN

Professor and Executive Officer

The Graduate Center, City University of New York (CUNY)

Professor, Hunter Bellevue School of Nursing, Hunter College

Question 1. According to the IOM Report Assessing Progress on the Institute of Medicine Report, the committee reported that the nursing profession has made a wide-reaching progress by providing quality, patient-centered, accessible, and affordable care in many aspects of its work although specific areas will require more focus and attention. You have written often the daunting responsibility that nurse educators have in preparing a workforce that is agile and ready for a changing health care system. Why do you believe nurse educators are called to the task?

They’re the lynchpin, nurse educators, because each and every day they enter their classrooms across this country where they apply their knowledge, their skills, their attributes to directly influence the future of nursing! They’re charged with producing a competent practitioner who must meet professional standards, understand Nursing’s Ethical Code of Conduct, but more importantly, make a promise to serve society. This is an enormous responsibility and we must insure that all of our students receive a quality education that prepares them to serve settings in which they will practice.

Question 2. What contributes to a quality education in these times and how do we measure the impact?

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Well I think the equation for measurement is really understanding that to build a highly skilled nursing workforce, we have to teach others to become nurses. That’s what we do as nurse educators: we teach others to become nurses. But in doing that, we have to recognize that if we do it well, we get a better educated nurse that translates to better health outcomes at lower cost.
It’s all about quality. It’s about the ability of the nurse educator to directly influence his or her students. How do we track that influence? That’s harder? How do we count the ways we make the difference knowing that we touch students so that students can go on and touch and transform the lives of those they care for? That’s hard, but I think the way that we can understand that is to know it’s not about how many students we touch but rather about our capacity to influence those that we are directly involved with – those that we are educating.

So, we recognize that they have the power to influence their practice by taking the knowledge, the theory and the attributes of nursing, applying that in ways that transform their places where they will be employed; also, being able to influence policy and advocate ways to improve the health and well-being society. An awesome responsibility! A tall order! But in education, we use what we have at hand. We take our innovative teaching strategies, our use of health information technology, our way of integrating scholarship and practice, nurturing partnerships among professionals and within communities, and we foster nurses to become global citizens who care deeply and passionately about the community they serve.

Question 3. How and where do we do this as educators in a changing world?

I think it’s simple. I think the answer is wherever we are – whether it’s in an urban, rural, suburban community across America, nurses must be familiar and insightful about their community, assess that community, and find the evidence that is most meaningful and appropriate to care for those populations that they are directly involved in. Simply, they must be champions of improving the outcomes of the health care experience for their individual patients – the families – the communities – and the populations in which they serve. And that means really understanding how to improve health care – understanding the culture of health. And when you do that, and you have those outcomes, you reduce cost because people access the care that they need.

When it goes back to then the role of the educator, what they need to do is they have to make sure that they created an educational infrastructure that includes the knowledge that’s required of them, but that often is changing in this society! Whether it’s regulatory, legislative, or local or regional standards of care, we have to know all about it! So it’s not just content per se, but it’s also knowing the demographics, knowing the disease prevalence, knowing about the conditions of the community (the health, the water, the infrastructure, the sanitation, the infectious diseases). It’s the work of Nightingale! It’s the work of knowing the data and how you make a difference with that data.

So what we are looking for is our ability to be excited about the work of the Future of Nursing Report and its update, but we have to be ready to make the changes when needed, to understand the role that we have as nurses (which is so powerful) and be able to influence our students so that they can go and influence the world that they are now a part of.